Color-coded Doppler sonography in the diagnosis of carotid artery diseases

Color-flow Doppler is a new development of duplex sonography of the peripheral vessels. In this study 844 consecutive patients were evaluated (a) to assess the comparative value of these two methods, (b) to see if there is a correlation between the degree of stenosis and the incidence of neurological symptoms and (c) to find a possible relationship between the plaque structure and the incidence of neurological deficits. (a) In 89%, the color-flow assessment was in complete agreement with the duplex assessment. In the remaining 11%, important additional results were discovered in the color flow examination. (b) Non-stenotic plaques were seen more often (43%) in the wide carotic bulb, stenotic plaques and occlusion were found more often (66 and 82%) in the internal carotic artery. Vessel occlusion was found most often in patients with cerebral ischemia. Color-flow Doppler demonstrated a higher incidence of hemodynamic stenosis in patients with peripheral vascular disease, hypertension and bruits. (c) Patients with heterogeneous plaques demonstrated a significantly higher risk of neurological deficits than those with homogeneous plaques. The great advantage of color-flow Doppler is that it enables sonomorphological (plaques, stenoses, occlusion) and functional parameters (turbulences, flow enhancement) to be studied during the same procedure.